CORA JOHNSON – Family Nurse Practitioner, NPI 1104658285

CORA JOHNSON is a healthcare provider. based in Sparks glencoe, Maryland. specializing in NURSE PRACTITIONER. They hold a License No. 0024190949 (VA). The NPI Number for CORA JOHNSON is 1104658285

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
CORA JOHNSON
NPI
1104658285
Phone
(443) 383-9300
Address
909 RIDGEBROOK RD STE 300
Enumeration Date
16 August 2024
Last Update Date
16 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4433839300
Graduation Year
2024 (2 years ago)
PAC ID
0941734057
Group Practice PAC ID
1254662695
Professional Enrollment ID
I20241112003915
Address ID
VA232331339HE3900XPKWY301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

8,307 NURSE PRACTITIONER in VA

Provider Addresses for CORA JOHNSON

  • 909 RIDGEBROOK RD STE 300

    SPARKS GLENCOE, MD 211529477

    Phone: (443) 383-9300

    Type: Mailing

  • 3900 WESTERRE PKWY STE 300

    RICHMOND, VA 232331339

    Phone: (443) 383-9300

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241112003915INurse PractitionerVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 21152)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254662695View full group profile
NameSpecialtyState
Nurse PractitionerNJ
Nurse PractitionerMD
Nurse PractitionerVA
General SurgeryPA
Nurse PractitionerNJ
Nurse PractitionerNJ
Nurse PractitionerMD
Nurse PractitionerVA
Nurse PractitionerMD
Nurse PractitionerMD

Reviews

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Frequently asked questions

Does CORA JOHNSON have a public NPI I can cite?
Public records show CORA JOHNSON under NPI 1104658285.
Is CORA JOHNSON currently accepting referrals based on NPI status?
Registry metadata lists CORA JOHNSON as active.
What services align with CORA JOHNSON's listing?
CORA JOHNSON's public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to CORA JOHNSON?
The directory associates CORA JOHNSON with Sparks Glencoe, Maryland. Check all listed addresses for suites or satellite offices.
Can I export CORA JOHNSON's record?
You can download the official NPPES record; we summarize key fields for readability.

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